采用3D-Tricks技术观察复发-缓解型多发性硬化患者颅外静脉特征

Observation on characteristics of extracranial venous system in patients with relapsing-remitting multiple sclerosis using 3D-Tricks

目的探讨复发-缓解型多发性硬化(RRMS)患者颅外静脉的形态学特征。方法对28例RRMS(MS组)和对照组19例患者进行三维时间分辨率对比剂动力成像(3D-Tricks),利用MIP和MPR技术对颈部血管进行重建。将轴位图像上的颈内静脉分为不显示、针尖状、扁平状、新月形及椭圆形5型,以不显示和针尖状为静脉狭窄。分析双侧颈内静脉的对称性和其他颅外主要静脉(颈外、颈前和椎静脉)的特征,比较MS组与对照组颅外静脉的形态学差异。结果 MS组4例、对照组2例颈内静脉狭窄,差异无统计学意义(P>0.05);MS组14例、对照组10例双侧颈内静脉不对称,差异无统计学意义(P>0.05)。两组之间其他颅外主要静脉特征差异无统计学意义(P>0.05)。结论 MS组与对照组颅外静脉系统特征无显著差异,不支持慢性脑脊髓静脉引流不足为MS的病因。

Objective To investigate the morphologic features of the extracranial venous system in patients with relapsing-remitting multiple sclerosis（RRMS）.Methods Totally 28 patients with RRMS（MS group） and 19 patients in control group underwent 3.0T MR scan using a three-dimensional time-resolved imaging of contrast kinetics（3D-Tricks） sequence.The jugular vessels were reconstructed with MPR and MIP techniques.Morphologic features of the internal jugular veins were classified into five categories： Absent（flow not visible）,pinpoint,flattened,crescentic and ellipsoidal flow.Both absent and pinpoint flows were considered as stenosis.The symmetry of the internal veins and characteristics of other jugular veins,including external jugular veins,anterior jugular veins and vertebral veins were analyzed.The morphologic features of the extracranial veins between MS and control groups were compared.Results Four of 28 MS patients and 2 patients in control group showed internal jugular vein abnormalities.No significant difference was found in the internal jugular veins stenosis between MS and control groups（P0.05）.Fourteen of 28 MS patients and 10 of 19 controls showed internal jugular vein asymmetry（P0.05）.No significant difference was found in characteristics of the others jugular veins between MS patients and controls.Conclusion No significant differences existed in the extracranial venous systems between MS patients and control subjects.The results did not support the chronic cerebrospinal venous insufficiency as an etiological factor in the development of MS.